The IRG Report


12

Jun 2017

Medicare Extends Reciprocal and Fee-for-Time Arrangements to PTs

CMS announced in a recent transmittal its implementation of a provision in the 21st Century Cures Act which will allow outpatient physical therapy services furnished by PTs in health professional shortage areas (HPSA), medically underserved areas (MUA), or in rural areas to be billed under reciprocal billing and fee-for-time compensation arrangements in the same manner as physicians, effective no later...

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09

May 2017

The Role of Outpatient PT in Bundled Payment Programs

As a follow-up to our Fast Track session at this year’s annual AAOE conference, I wanted to revisit some key points that we discussed in regard to the role outpatient physical therapy can play in bundled payment scenarios.  Those already participating in CJR, BCPI, or other commercial bundles for total joint replacements have witnessed first-hand the trend of decreased utilization...

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26

Apr 2017

An Update on the Physical Therapy Compact

As mentioned in a previous blog post, the multistate licensure compact is moving ever closer to reality.  With Washington recently bringing the number of states who have agreed to join the compact to the minimum number of 10, the process can now move to the next step. To review, the purpose of the interstate compact is to reduce regulatory barriers...

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09

Apr 2017

Revised ABN Form Released by CMS

CMS has released an updated version of the Advanced Beneficiary Form (ABN) form which includes a newly incorporated expiration date on the form as well as language informing beneficiaries of their rights to CMS nondiscrimination practices and how to request the ABN in an alternative format if needed.  The effective date for use of the new ABN form is 6/21/2017. ...

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23

Feb 2017

CMS Announces Proposed Rule on Orthotics and Prosthetics Qualified Providers

On January 11th, 2017, CMS released a proposed rule (CMS-6012-P) which would have a significant impact on eligible professionals who furnish custom-fabricated orthotics and prosthetics.  The rule, titled “Establishment of Special Payment Provisions and Requirements for Qualified Practitioners and Qualified Suppliers of Prosthetics and Custom Fabricated Orthotics,” removes exemptions to quality standards and orthotic certification for OTs and PTs, and...

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19

Dec 2016

Recent Legislation Includes Limited Locum Tenens Provision for Physical Therapists

The 21st Century Cures Act, which was passed by the House and Senate earlier this month and signed into law by President Obama on December 13th, includes a provision which will allow physical therapists to enter into locum tenens arrangements and bring in another licensed physical therapist to treat Medicare patients and bill through the practice provider number during temporary...

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25

Nov 2016

Preparing for the New Therapy Evaluation Codes

The time is now to start preparing for the new evaluation and re-evaluation codes that will go into effect on January 1st, 2017.  As mentioned in the previous blog post, the current PT and OT evaluation and re-evaluation codes have been removed from the AMA CPT manual and replaced with three new evaluation codes and one new re-evaluation code for...

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13

Oct 2016

New Evaluation and Re-Evaluation Codes Are Coming in 2017

Drastic changes are coming to evaluation and re-evaluation codes for physical and occupational therapy in 2017.  As of January 1st, 2017, the current evaluation and re-evaluation codes (97001, 97002, 97003, and 97004) will be removed from the CPT code list and replaced with three new evaluation codes for both PT and OT along with one new re-evaluation code for each discipline. ...

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24

Sep 2016

South Carolina Supreme Court Overturns Ban on Integration of Physician and PT Services

The South Carolina Supreme Court has overturned a previous ruling which prohibited physicians from employing physical therapists in the Palmetto State.  Issued on September 14th, the Court’s decision in Joseph et al v South Carolina Department of Licensing, Labor, and Regulation, South Carolina Board of Physical Therapy concludes the decade-long fight over physician employment of PTs by overruling the Court’s 2006...

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